• Utilization Management Nurse

    Humana (Tallahassee, FL)
    …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...appropriate courses of action. As a Utilization Management RN working on the OneHome/ Home Solutions… more
    Humana (09/12/25)
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  • Utilization Management Nurse

    Humana (Tallahassee, FL)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
    Humana (11/24/25)
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  • Utilization Management Nurse

    CenterWell (Tallahassee, FL)
    …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
    CenterWell (11/22/25)
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  • SNF Utilization Management RN…

    Humana (Tallahassee, FL)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
    Humana (09/12/25)
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  • UM Behavioral Health Nurse

    Humana (Tallahassee, FL)
    **Become a part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work… more
    Humana (11/27/25)
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  • Case Manager Registered Nurse - Work…

    CVS Health (Tallahassee, FL)
    …is subject to change based on business needs. **Preferred Qualifications** 6+ months Case Management or Utilization Management experience Case Management ... responsible for telephonically assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the… more
    CVS Health (11/23/25)
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  • Case Manager, Registered Nurse - Fully…

    CVS Health (Tallahassee, FL)
    …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse more
    CVS Health (11/27/25)
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  • Operating Room Nurse - Surgery Center

    HCA Healthcare (Tallahassee, FL)
    …passionate about delivering patient-centered care?** Submit your application for Operating Room Nurse - Surgery Center position and spend more time at the bedside ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage,… more
    HCA Healthcare (10/07/25)
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  • Operating Room Nurse PRN-Surgery Center

    HCA Healthcare (Tallahassee, FL)
    …**Introduction** Do you have the PRN career opportunities as an Operating Room Nurse PRN-Surgery Center you want with your current employer? We have an exciting ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage,… more
    HCA Healthcare (10/04/25)
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  • Clinical Reviewer, Nurse

    Evolent (Tallahassee, FL)
    …responsible for support and assistance for all cardiology administrative and clinical utilization management and quality improvement functions under the auspices ... is 11:30-8:00 eastern** **OTHER SKILLS and ABILITIES:** Strong clinical, management , communication, and organizational skills. Demonstrated leadership skills Analytic… more
    Evolent (11/20/25)
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  • Manager Case Management

    HCA Healthcare (Tallahassee, FL)
    **Description** **Introduction** Do you have the career opportunities as a(an) Manager Case Management you want in your current role? We invest in what matters most ... to nurses like you - at home , at work, and at every stage in your...needs. + Develops, initiates, and coordinates individual patient case management plans to ensure appropriate level of care across… more
    HCA Healthcare (11/10/25)
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  • Director PI Bed Management

    HCA Healthcare (Tallahassee, FL)
    …to Patient in Bed by facility by floor to identify opportunities + Assesses utilization of Bed Management technology for optimal use + Performs staffing ... want to join an organization that invests in you as a(an) Director PI Bed Management ? At HCA Healthcare, you come first. HCA Healthcare has committed up to $300… more
    HCA Healthcare (11/26/25)
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  • RN Case Manager Evenings

    HCA Healthcare (Tallahassee, FL)
    …and assess observation patients for appropriateness in observation status + Performs utilization management reviews and communicates information to third party ... is acceptable for position if current and compliant** + **Certification in Case Management , Nursing, or Utilization Review, preferred** + **Three years of… more
    HCA Healthcare (11/10/25)
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  • RN Case Manager Part Time

    HCA Healthcare (Tallahassee, FL)
    …and assess observation patients for appropriateness in observation status + Performs utilization management reviews and communicates information to third party ... is acceptable for position if current and compliant** + **Certification in Case Management , Nursing, or Utilization Review, preferred** + **Three years of… more
    HCA Healthcare (11/10/25)
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  • RN Case Manager

    HCA Healthcare (Tallahassee, FL)
    …and assess observation patients for appropriateness in observation status + Performs utilization management reviews and communicates information to third party ... is acceptable for position if current and compliant + Certification in Case Management , Nursing, or Utilization Review, preferred + Three years of nursing… more
    HCA Healthcare (11/10/25)
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  • Family Health Advocate - Remote

    Sharecare (Tallahassee, FL)
    …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex...and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and case… more
    Sharecare (11/22/25)
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  • Child Protective Investigator Supv-SES

    MyFlorida (Tallahassee, FL)
    …+ Therapeutic Assistant + Behavioral Health Technician + Family Intervention Specialist + Home Health Aide + Nurse (LPN or RN) or similar profession ... Supervise, plan and direct workloads, workflows, deadlines, work objectives and time utilization of subordinate staff in the delivery of protecting children, working… more
    MyFlorida (11/25/25)
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